Friday, February 18, 2005

Skin disease-also called cutaneous disease-is very common in lupus erythematosus (LE). Only joint pain (arthritis) is more common. People with lupus can develop many different types of skin lesions. The term "skin lesion" used here refers to a distinct area of abnormal skin.

Lupus skin disease can be divided into two broad categories:

Skin lesions that are seen only in people with LE.These three types of lesions are:

Systemic Lupus And Discoid LupusA frequently asked question by people with lupus is:"What is the relationship between systemic LE (SLE) and lesions seen in discoid LE (DLE)?"

Lupus can be viewed as a disease continuum or spectrum:

* At the mild end of the spectrum are the minimally affected LE patients. They will have only localized DLE skin lesions.* At the other end of the spectrum are patients who have active SLE with internal organ involvement. They will have ACLE skin lesions or no skin lesions at all.* SCLE patients tend to fall toward the middle of the spectrum since they often have some evidence of mild SLE.

People with DLE lesions and no clinical evidence of SLE usually do not produce autoantibodies in their blood (i.e. antinuclear and anti-DNA autoantibody tests are negative). On the other hand, SLE is characterized by the presence of one or more types of such autoantibodies.

* Of the patients who initially have only DLE lesions, approximately 10 percent will go on to develop SLE.* Of the patients with SLE, approximately 20-30 percent will develop DLE lesions at some time during the course of their disease.

Whether DLE lesions are occurring alone or as a result of SLE can only be determined by: 1.) performing a complete medical history2.) physical examination3.) a set of appropriate blood tests.

* Approximately 20 percent of people with SLE will have DLE as their initial disease symptom.* An additional 10 percent of people with SLE will have subacute cutaneous LE (SCLE) skin lesions as their initial disease symptom.* In addition, approximately 60-65 percent of people with SLE will develop some type of skin problem during the course of their illness.

However, skin lesions in people with lupus are less of a problem with the use of:

* DLE lesions are often red, scaly, and thickened. As the lesions get older they can produce scarring and discoloration of skin (darkly colored and/or lightly colored areas).* When DLE lesions occur in the scalp, hair loss (alopecia) can result. This form of hair loss is often permanent.* DLE lesions are usually painless and typically do not itch.* Skin cancer can occasionally develop in long-standing DLE lesions; therefore, any changes in a long-standing DLE lesion should be brought to your doctor's attention.

Other forms of CCLEHypertrophic or verrucous* DLE lesions that develop very thick scale (hyperkeratosis) are referred to as:

hypertrophic (thickened) lesions OR verrucous (wart-like) lesions.

Lupus profundus * DLE lesions may also occur in conjunction with firm lumps in the fatty tissue underlying the skin (panniculitis). This form of panniculitis is called lupus profundus.

Mucosal DLE is the name given to the lesions that occasionally occur in the mucus membranes of the mouth, nose, and eyes

Palmar-plantar DLE is the name given to the lesions that occasionally occur on the hands and feet.

Subacute Cutaneous LE (SCLE)Two clinical forms of SCLE lesions

1.) The papulosquamous variety of SCLE is characterized by red (erythematous) plaques-elevated areas of scaly skin with distinct margins.* This form of SCLE can resemble psoriasis.* These lesions appear most commonly on the sun-exposed areas of the arms, shoulders, neck and trunk, with the face being affected less frequently.2.) The other form of SCLE consists of red annular (ring-shaped) lesions occurring on the same parts of the body.* Both forms of SCLE are characteristically very photosensitive. This means they get worse when exposed to sunlight or artificial sources of ultraviolet light.* Unlike DLE, SCLE lesions do not scar.* However, they can produce areas of light or dark skin discoloration.As with other forms of cutaneous LE, SCLE lesions usually do not itch.* Occasionally, other forms of LE skin disease-such as DLE and ACLE-can develop in SCLE patients. In these cases, ACLE could be a warning sign for the development of a more severe form of SLE.

Diagnosing SCLE * Approximately 50 percent of patients with SCLE will have a diagnosis of SLE.* However, more severe forms of SLE are quite unusual and occur in less than 19 percent of SCLE cases.

These cases will be characterized by:

disease in the kidneysdisease in the braindisease in other vital organs

* Ro/SS-A autoantibodies are found in the blood of approximately 70 percent of SCLE patients. This is the same autoantibody that is produced by patients with Sjogren's syndrome.* The skin lesions seen in infants with neonatal LE are similar to SCLE lesions.The neonatal LE syndrome results when infants are born to mothers who have Ro/SS-A autoantibodies in their blood during pregnancy.* Neonatal LE skin lesions usually spontaneously disappear by six months of age.A very small percentage of women with SCLE skin lesions are at risk for having a baby with neonatal LE or heart damage at birth (congenital heart block).

Acute Cutaneous LE (ACLE)The most typical form of ACLE consists of flattened areas of red skin on the face that resemble a persistent sunburn.

Localized ACLE is seen when both cheeks and nose are involved. The redness can simulate the appearance of a butterfly.

Generalized ACLE is the more widespread form.This redness can be seen on the arms, legs, and body, and often produces a rash-like appearance

ACLE lesions tend to be very photosensitive.

* They typically do not produce scarring, although skin discoloration can be seen.* ACLE is often seen in people who have active, sometimes severe, SLE.

Skin Lesions In LE And Other DiseasesIn general, this category of LE skin disease occurs in patients who also have SLE.

VasculitisSLE patients may develop damage of the blood vessels in the skin called cutaneous vasculitis.

* Cutaneous vasculitis lesions typically appear as small red-purple spots and bumps on the lower legs (palpable purport).* Occasionally, larger knots (nodules) and ulcers can develop.* Vasculitis lesions can appear in the skin as hive-like or wheal-like lesions (urticarial vasculitis).* The lesions also can appear as small red or purple lines or spots in the fingernail folds or on the tips or the fingers.

Hair Loss (Alopecia)There are several forms of non-scarring hair loss which are not related to the presence of DLE of the scalp.* SLE patients who have been severely ill with their disease may develop a temporary pattern of hair loss which is replaced by new hair growth. This condition is known as telogen effluvium.* A severe flare of SLE can result in fragile hair that breaks easily. Such broken hairs at the edge of the scalp give a characteristic ragged appearance termed "lupus hair."

Additional Forms of Skin Disease Seen in LE as Well as Other DiseasesThere are a number of other forms of skin disease in this category, such as :

Photosensitivity Photosensitivity is a common feature of both cutaneous LE and SLE. The overwhelming majority of LE skin lesions occur on sun-exposed areas.* Approximately 40-70 percent of people with LE will note that their cutaneous and/or systemic disease is aggravated by sun exposure.* SCLE lesions are somewhat more likely to be worsened by sunlight exposure than DLE lesions.* It is the sunburning ultraviolet B (UV-B) rays in sunlight that are particularly bad for LE patients.* Longer wavelength ultraviolet A (UV-A) rays can also aggravate cutaneous LE, especially SCLE. As an example, a standard pane of window glass blocks UV-B rays but allows UV-A rays to pass through.

Sun Protection Sun protection is extremely important for people with both cutaneous LE and SLE.

1.) Avoid prolonged periods of exposure to sunlight, especially between the hours of 10 a.m. and 3 p.m. when the sun is at its brightest. (Use this rule: if your shadow is as long as you are tall, it's okay to be outside).2.) Avoid exposure to reflected sunlight around highly reflective surfaces, such as sand, water, and snow.3.) Avoid artificial sources of ultraviolet rays, such as being near unshielded fluorescent lighting tubes.4.) Ensure physical protection from sunlight by using wide-brimmed hats and umbrellas.

* Tightly-woven, light-weight clothing can provide significant sun protection (specially-designed sun protective clothing is available commercially).* The regular use of broad-spectrum sunscreens with a sun protective factor (SPF) rating of at least 15 is strongly recommended.* The broadest protection against both UV-A and UV-B is in sunscreens that contain avobenzone (Parsol 1789), titanium dioxide, and/or zinc oxide.

Treatment of LE Lesions * Treatment of all forms of LE skin disease begins with the use of sunscreens.* ACLE is usually treated with systemic drugs such as prednisone to suppress accompanying SLE symptoms.* DLE and SCLE skin lesions can be treated with the application of steroid creams, ointments, gels, and solutions.* In addition, individual lesions can be covered with steroid-impregnated tape or injected with a steroid solution.

More widespread LE skin lesions and lesions that do not respond to the above local measures can be treated with systemic antimalarial drugs such as hydroxychloroquine capsules (brand names: Plaquenil, Quineprox).

* This drug is given by mouth, alone or in combination with quinacrine capsules and/or a short burst of steroids (prednisone).* In stubborn cases it will be necessary to substitute chloroquine (brand name: Aralen) for hydroxychloroquine.Cutaneous LE lesions respond better to antimalarial therapy when the patient is not smoking cigarettes.

Other oral drugs that can be of benefit in resistant cutaneous LE cases include:

Dealing With The Effects Of LE Lesions * When properly blended and applied, corrective camouflage cosmetics can temporarily mask the appearance of the skin discoloration and scarring that can result from cutaneous LE lesions.

* Plastic surgery techniques to correct scarring from cutaneous LE can be somewhat risky. However, such techniques may be considered while the patient is under active treatment with drugs such as antimalarials. These will prevent the aggravation of skin disease that can occur in people with LE who also have any form of skin injury, including surgical manipulation.

For specific information regarding the treatment of various skin manifestations of LE, as well as the proper selection and use of sunscreens, consult your dermatologist or your local chapter The African-American Lupus Foundation, Inc.

The African-American Lupus Foundation, Inc.The Lupus Foundation of America (LFA) was established in 1990 to educate and support those affected by lupus and find the cure. The AALF, Inc. supports research, education, awareness, patient services, and advocacy.

The African-American Lupus Foundation is a nationwide organization exclusively serving individuals, families and friends affected by lupus. The AALF, Inc. has local chapters and support groups throughout the United States, as well as international affiliates around the world. Contact the AALF, Inc. or the chapter that serves your area to find out how you can become involved in our mission.

Become a Lupus E-Advocate and help pass federal legislation that will benefit people with lupus. You'll receive periodic advocacy updates and other breaking lupus news and information.

For information about lupus or to locate the chapter nearest you, visit our website at www.aalfinc.org or call our information request line toll-free at (1-800-822-0206).

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My name is Amanda Nourse and i would like to show you my personal experience with Accutane.

I have taken for 6 days. I am 27 years old. My dermatoglogist put me back on Accutane partially because Klaron, Rentin A, & Doxycyclin were NOT working....I have been on Accutane before about 7 years ago so not too concerned about the side effects. With my previous run on this medicine I didn't have the severe back aches. I will say I did have tons of issues registering with the IPledge website...all too confusing all to combersome! Didn't have to do that 7 years ago. Since this is my 2nd go round I can say that for me there were no depression issues because my skin looks awesome ...tons of compliments. As with all things once I stop so will the side effects. This medication is obviously for those with severe acne so you should certainly weigh the pros vs. the cons...for me I didn't think twice...

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Ideas on How to satisfy Ladies for the Shopping mall

If one is just one guy and aren't the prime at obtaining very much much less meeting girls and are questioning wherever you would possibly visit unearth and interact with a female, then these ten sensible guidelines on how to satisfy a woman in the mall, need to come in mighty handy.

1 - Go to the foods court. Think it or not, the foodstuff court is a absolute excellent position inside shopping mall to meet a chick. Here's what you do. Choose a foods area and get in line for the meal. When you may be in line, glance all-around the area where everyone is sitting and eating. Start looking for the lady seated alone, as well as two ladies sitting down together. When you've got your meal in hand, walk more than to exactly where she or they're sitting and ask if you may join them. If you are trustworthy and straightforward with them, your chances are fairly fantastic.

2- Do some contemplating. Before you even give thought to heading for the local mall to satisfy a woman, sit yourself down and do some serious considering. Ponder how you could possibly satisfy a young girl and what you could say to her if you’re thriving. Think of which parts associated with the shopping mall you'll visit. Also, you are gonna have to invest in a little something whilst there, what do you need? At last, take into consideration what meeting a young girl in the public site entails. Unquestionably you may have to check for the wedding ring in advance of speaking with a girlfriend, and you are going to should give some thought to if it's wiser to speak to a lady alone or a single who is with others. In conclusion, you will have being reasonable about your own age and the ages within the gal you need to satisfy. As in, you will really have to tell on your own being sensible and don't have a shot at to meet ladies that are substantially younger or older than you are, or that glimpse out of the league.

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Playing bingo needs more than luck or skills and techniques, contrary to what most believe. Bingo, just like any game of chance, comes with rules and regulations that players should observe. Being a player comes with responsibilities and etiquette.

Winning the Game

The moment you figured out you won, you must immediately yell BINGO, and it should be loud enough for the floor walker to hear. The pot money shall be given to the winner once their winning card is confirmed. Well, in winning or once you know you just won, the most important thing is that you shout the winning word BEFORE the time elapses. If the game proceeds and the next number is mentioned and you failed to shout "Bingo", your winning card is disqualified. Therefore, this is the rule you must know.

There may be cases when there are two winners, and in this case the pot money shall be divided equally among the winners. Supposing there are two winning cards, the two winners will share half the prize money.

Bingo Game Rules

Bingo rules are basically the same no matter in which Online Bingo hall you play. But still it's good if you know these rules by heart. If it is your first try, then ask for handouts and inquire from pros regarding the game rules. Nonetheless, the ideal thing to do if you have questions is to ask the floor walker and not the person seated beside you. You should clarify things and doubts before the game starts because asking too many questions as the game proceeds could well distract you. This guideline also applies to those who are newcomers at casinos, those who play roulette for the first time.

Bingo halls demand an age limit of 18 years old. If you are below this age, you are prohibited to play. Some bingo houses ban alcohol inside, so players aren't supposed to take liquor nor drink it inside the venue. Smoking may also be restricted inside the venue, as there are designated smoking sections.

Take note that some Bingo houses don't allow food but some do, so it basically depends on the venue. Policies vary among different venues. For instance, some bingo halls allow reservation of cards, while others don't allow it. Some allow people to leave the venue in the middle of the game, others forbid it. But there are general policies observed in all bingo houses, such as disqualification of tampered bingo cards. There is no way you can get away with a tampered card because the walkers are adept at identifying authentic cards from tampered ones. You could be banned from a bingo establishment if proven liable of tampering a card. Hence, you should play honestly.

Interestingly, some venues offer special bingo games for kids although some halls don't allow players to have companions while playing. Suppose you bring kids with you, don't let them run around the venue and bother other gamers. They should behave well whilst you play and the game proceeds. Play quietly and don't recite the numbers you desperately want to come off because you'll be much of a disturbance if you do. Decorous playing is expectant of all players, even those who play roulette at casinos. Also, having a valid identification is important because you don't know you might win and need to present credentials.

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About

Lupus is a chronic, autoimmune disease which causes inflammation of various parts of the body, especially the skin, joints, blood and kidneys. The body's immune system normally makes proteins called antibodies to protect the body against viruses, bacteria and other foreign materials. These foreign materials are called antigens.

About Me

Carol Taylor is the founding Executive Director of the African American Lupus Foundation Inc., in 1990 and the sole owner of Carol Taylor Associates Inc., a management, consultant and training firm. Carol graduated from the University of Minnesota with a Masters Degree in English Education and Curricululm in 1982. She was a candidate for the Doctoral Degree in Education Administration when she was diagnoised with Lupus Erythematosus (SLE) in 1985. After spending five years in treatment and recovery, Carol begin her road back to engaging in an active life after Lupus. With Lupus in remission, Carol became active and performed volunteer counseling of other women with Lupus, especially African American and other women of color. With the support of the Minnesota State Department of Vocational Rehabilitation, The Lupus Foundation of Minnesota, The Disability Alliance Council, The Governor's Council on Disabilities and The United Way of Minnesota, Carol was able to find support that she needed to make her feel valued, rewarded and recognized in the community.